Chief Investigator: Dr Natasha Campling, University of Southampton

Funder: Marie Curie Research Grants Scheme

Start Date: 1st March 2023

End Date: 7th October 2025

Partners: Research & Development Department, South East Coast Ambulance Service, University of the West of England, University of Southampton

Summary

Paramedics are often important to patients in the last year of their life (end-of-life). We know that 999 calls are increasing for individuals and their families at end-of-life, which may be because services in the community are under pressure e.g. those provided by family doctors and community nurses. Little wide scale research has been carried out to understand the contribution played by paramedics in these situations and how this might be improved. From practice it is known that paramedics attending patients at end-of-life face complex issues such as: not knowing the patient or their family, lack of availability of patient history, fear of doing wrong, issues with family conflict and a lack of healthcare professionals to hand over to out-of-hours if the patient is to remain at home. These issues can mean people are admitted to hospital when circumstances mean they could be cared for at home.

The purpose of the study is to evaluate services and care provided by paramedics to people in the last year of life. We will survey paramedics throughout England to understand their professional practice and what factors influence this and conduct in-depth case studies (collecting information from patients, carers and healthcare professionals) to examine different ways of delivering services and how these shape paramedic decision-making and management of risk. It is important to evaluate service delivery and understand how the best service features can be incorporated into other services to improve the quality of care and support provided to patients and their families. This may prevent unnecessary hospital admissions at end-of-life, which often leads to people dying in hospital when most people state they would prefer to be cared for, and die, at home.

The research will describe, characterise and evaluate paramedic delivered end-of-life service provision to answer the research question: how do different models of service provision shape paramedic practice and influence experiences and outcomes for individuals at end-of-life? The evaluation will enable service delivery models, their features, and effective risk management by paramedics to be distinguished to facilitate sharing of best practice and improve the quality of care and support for people at end-of-life.